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Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
March, 2005, Vol. 05, Issue 03
The Inside-Out Paradigm: Equalizing the Pressure
By Dale G. Alexander, LMT, MA, PhD
Read Dale's previous article, "Healing From the Core: A New Paradigm," Parts 1 & 2, in the Sept. and Oct. 2004 issues of Massage Today at: www.massagetoday.com/archives/2004/09/20.html and www.massagetoday.com/archives/2004/10/04.html.
This article will explore a few of the many elements of anatomy and physiology that are fundamental to the proposed paradigm of working from the "inside-out." My first article, "Healing From the Core: A New Paradigm," postulated three core elements that assist the healing process:
The centerpiece of this paradigm is simply to work with how the body maintains itself physiologically and proprioceptively at the same time. Most biomechanical models infer that the source of constricted vascular circulation is the result of the extrinsic musculature's battle to maintain body posture within and against the field of gravity. This is partially accurate. However, it is postulated that contraction of the visceral suspension is a more primary source of vascular congestion and that much of what throws the proprioceptive balance off in the first place is the result of how the body discharges visceral tension into the intrinsic musculature, which then affects the kinetic chain of the joints, thus placing a demand on the extrinsic musculature to contract in order to protect individual joints and the overall balance of an individual. It is a complex both/and scenario. But with further exploration, it will become clearer.
An overlooked aspect of anatomy in our work as massage therapists is that the human body has three great cavities designed to assist the movement of fluids and support the upright carriage of our human structure based on the pressure differences between them. These are the abdominal-pelvic; the thorax; and the cranium.
According to Dr. Jean-Pierre Barral, the developer of Visceral Manipulation, the pressure of the thoracic cavity in a healthy system is negative in relation to the more positive pressures within abdominal-pelvic and cranial cavities. This negative pressure also acts like a helium balloon to support our posture in the field of gravity.1
This difference in the pressure relationships between the cavities is how the efficiency of the low pressure venous and lymphatic systems is normally maintained in their job of returning their fluids back to the heart and lungs to be re-nourished and recycled. Let us remember that fluid moves from an area of greater concentration to an area of lesser concentration naturally. Thus, as one assists the body to re-establish the negative pressure within the thoracic cavity, it allows for an equalization of pressures between the cavities.
How does one tell if the thoracic pressure has become more positive with a client on your massage table? Simple palpation and soft compression of the thorax will readily indicate to you the degree of positive pressure. The less flexible the thorax, the more positive the pressure and, by inference, the slower the flow of venous and lymph return.
Within the body's three great cavities are four visceral sacs:
Each of these sacs is related to physiological waves of expansion and contraction, which are crucial to normal fluid circulation. Their rhythms support the healing process and maintain normal homeostatic regulation:
All of these rhythms are influenced by the pressure within the cavities and sacs, and by the pressure of the tubes within the sacs and by the pressure within those tubes, which pass between the sacs and cavities. Obviously, this adds emphasis to the tone and length of the esophagus, as it is the connecting tube between the cranial vault, thoracic cavity, and abdominal/pelvic cavity. It offers a release valve to the pressures, which often build up within the alimentary canal in addition to the anus at the lower end.
These rhythms are homeostatically regulated between the two divisions of the Autonomic Nervous System; the parasympathetic outflow of the vagus and pelvic splanchnic nerves and the sympathetic nerves exiting from T1-L2 of the spinal cord. It is the flexibility between these two divisions, which regulates who gets the blood thereby the oxygen and nutrients needed to support the healing process.2
How does this pressure in the tubes, sacs and cavities build in the first place? By soft-tissue contraction of the sacs and tubes of the viscera, which lessens the space for the liquids and gases within them. This internal contraction pressurizes the contents. When this pressure is unable to equalize, it builds. The building of pressure creates more soft-tissue tension. The cycle repeats again and again. The body attempts to distribute these tensions both directly and reflexively.
The theorized direct method was described in the first article: visceral tensions build, then spill over into the intrinsic musculature, which then pull on the osseous system until a dysfunction of motion is created affecting joint range of motion. This both releases some of the internal pressure, but also stimulates the extrinsic musculature to contract to protect the joints from further displacement. Inevitably, one's posture and sense of balance is also affected.
The reflexive method involves the distribution of tensions and strain through more generalized viscero-somatic reflex arcs. These relate to both segmental levels of the spinal cord and regional areas that have come to be recognized by surgeons as indicators of acute organ pathology.
What I've come to realize is that the body is organized to use the joints of the axial and appendicular skeleton in a very similar fashion to an electrical circuit-breaker system in a more modern home. Organ correlation to segmental levels of the spinal cord are referred to as spinal correspondences and are maps to the work of chiropractors and the osteopaths who directly manipulate the joints.
Regional reflex areas, such as the right shoulder/scapula area associated with liver/gall bladder congestion, stasis and disease, are referenced in some medical textbooks but are more commonly found, and their relevance more usefully described, in surgical references.3
The paradigm of working from the "inside-out" suggests that as massage therapists, we need to learn how to equalize the pressures within the tubes, sacs, and cavities of the body as a first step to assisting our clients. Additionally, knowledge of the aforementioned spinal correspondences and regional reflex areas can be invaluable for making timely and appropriate referral of our clients to medical care from the onset of working with them, or when they are not making progress.
Competent massage therapy of any orientation will assist stress-induced states of congestion to dissipate with a lessening or disappearance of the initial symptoms. When this doesn't occur, it is our ethical responsibility to encourage medical evaluation. A "well-baby" visit to a physician can be invaluable to the mental health of a client who fears something is amiss.
Stress-related problems follow the progression offered in the first article: adaptation, compensation/substitution, injury/illness, degeneration/disease. Trauma simply speeds one along the continuum. It is common for a client to have all the relevant medical tests and return for additional work as what is brewing within them has not reached the tipping point of recognizable pathology.
Now to lightly kiss the question of why stress affects some people more than others and some in particular areas, while others in totally different ways. As humans, we assign meaning to our experiences in life. We develop a complex array of positive and negative anticipations to events. We live in the models of our mind more than in the present time, experience of life unfolding moment by moment. This is the arena of consciousness and is the most powerful tool for change and evolution for ourselves and our species.
My experience professionally and personally reflects an additional existential theorem, as well: Our bodies are our vehicles for the development of consciousness, the growth of our soul and spirit, and the integration of our personality and spirit. Our bodies are where the action is happening. It embodies our confusions and terrors, our willingness and readiness for change. The body really does reflect a Map of Consciousness.4
Touch bridges time and space, and is the vehicle for re-modeling our inner landscape of attitudes, possibilities and behavior.
For those new to the profession, much of this may have been more than a mouthful, or simply tedious reading, yet it is what we are challenged to hold in our work, and there is more. It has taken years of concentrated experience and study across many disciplines to tease apart the foundational elements of anatomy and physiology to make sense of how the gestalt of the body works in relation to its dance with the psyche.
In truth, this paradigm of working from the inside-out is only the springboard for many connections that are to come in future years.
These basics, and others to follow, have consistently shown themselves to be fundamental to working with clients, especially those with chronic problems. Our real challenge is to expand our perception broadly to include additional dimensions and to nurture our quality of touch to assist our clients to integrate themselves across the many levels of human consciousness.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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